Is my baby at risk if I’m pregnant and have diabetes?

Your unborn baby has a higher risk of problems if you have type 1 or 2 diabetes. However, you can reduce these risks by monitoring your blood sugar levels:

  • before you conceive
  • during your pregnancy

What are the risks?

Your baby may be at risk of:

  • not developing normally and having congenital abnormalities, particularly heart abnormalities
  • being large for gestational age, which increases the likelihood of birth trauma, induction of labour and caesarean section
  • being stillborn or dying soon after birth
  • having health problems shortly after birth (such as heart and breathing problems) and needing hospital care
  • developing obesity or diabetes later in life

Before pregnancy

There are steps you can take before you conceive that will reduce the risks to your baby:

  • Contact your diabetic care team, if you have one, or speak to your GP. They’ll give you advice and support about preparing for pregnancy.
  • Get your blood sugar levels checked. Your blood sugar targets may have changed. To reduce the risk of birth defects, keep using contraception until your blood sugar level is well controlled. 
  • Get your medications reviewed. You may be advised to take metformin instead of insulin and to change any blood pressure medicines you take.
  • Have an eye test. People with diabetes are at risk of an eye condition called diabetic retinopathy. Treat any eye problems before you become pregnant.
  • Have your kidneys checked. Your urine will be tested to check that they’re working properly.  
  • Stop smoking and drinking alcohol. These are harmful to unborn babies. Alcohol also affects your blood sugar level.
  • Eat a healthy diet. Your diabetic care team will advise what foods can control your blood sugar levels. If your body mass index (BMI) is over 27, you may be advised to lose weight.
  • Take a 5 milligram (mg) folic acid supplement before conception, and continue until week 12 of your pregnancy. This is higher than the 0.4mg standard dose for pregnant women.

During pregnancy

  • Attend all your appointments at a joint antenatal and diabetic care clinic. Women with diabetes should see a diabetes care team for an assessment of glycaemic control every one to two weeks throughout pregnancy. 
  • You should be offered an eye test after your first antenatal appointment and again at 28 weeks.
  • Your kidneys should be assessed as soon as possible, unless they’ve been tested in the previous 12 months. 
  • Test your blood sugar levels before meals, one hour after meals and before bed. Report any changes to your diabetic care team.
  • You may be given ketone testing strips to use if your blood sugar level is too high. If ketones are present in your blood, this may be a sign of diabetic ketoacidosis, which will need hospital treatment.
  • If you use insulin, keep a glucagon emergency kit at home. Make sure you and others at home know how and when to use it.
  • You’ll be offered extra antenatal appointments. Your unborn baby’s heart, foetal growth, and your amniotic fluid volume will be checked with an ultrasound scan around weeks 18-20. You’ll also have ultrasounds at weeks 28, 32 and 36.

Read more about diabetes and pregnancy.

Further information:

Page last reviewed: 13/03/2015

Next review due: 12/03/2017